Test-retest reliability of Latin American Group for Maturity (GDLAM) protocol in older women

by Álvaro Huerta Ojeda, Emilio Jofré-Saldía, Jimena Arriagada Molina, Patricia Rojas Quinchavil, María Paz Parada Toledo, Sergio Galdames Maliqueo, María-Mercedes Yeomans-Cabrera, Carlos Jorquera-Aguilera, Frano Giakoni-Ramirez, Maximiliano Bravo

Functional autonomy (FA) is a critical factor in determining the quality of life of older adults (OA), especially in the case of older women (OW), as they face a decline in FA in their later years of life. FA should be assessed early, using valid, reliable, and low-cost tests. This study evaluated the test-retest reliability of GDLAM and GDLAM autonomy index (GI) in OW. Thirty-nine OW (71.2 ± 6.50 years) participated in the study. A repeated measures design was used to compare the interday test-retest reliability of the five GDLAM tests (seconds) and the GI (points). The five tests represent activities of daily living, such as dressing or wandering around the house, while the GI provides a weighting of the results of the five tests. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ≤ 10% and an ICC ≥ 0.80 were considered acceptable reliability, whereas a CV ≤ 5% and an ICC ≥ 0.90 were considered high reliability. The outcome of the five tests, represented by the GI, showed high interday test-retest reliability (CV = 6.00% and ICC = 0.91). The results of this study demonstrate that the five tests of the GDLAM protocol and the GI have high interday test-retest reliability and good interday reproducibility. From a practical point of view, the GDLAM protocol allows the assessment of FA of community-dwelling OW, providing background for early diagnosis and, with it, the possibility of developing an individualized physical exercise prescription.

The Effect of QR Code–Supported Patient Training on Total Knee Arthroplasty–Related Problems and Emergency Department Admission Rate

Knee arthroplasty surgery, which is increasingly performed due to increased life expectancy, has positive outcomes, although it can also cause serious health problems following surgery. This study was conducted to evaluate the impact of patient-related education via a QR code on total knee arthroplasty problems and emergency department referral rates. Participants were randomly assigned to intervention (n = 51) and control (n = 51) groups. The intervention group received QR code–supported training. The outcomes were assessed at baseline (preoperative), discharge, and postoperative sixth week. In the intervention group, significantly fewer problems related to total knee arthroplasty occurred at discharge and in week 6, and a higher level of functionality was noted (P

Creating a psychosocial intervention combining growth mindset and implementation intentions (GMII) to reduce alcohol consumption: A mixed method approach

by Sacha Parada, Bérengère Rubio, Elsa Taschini, Xavier Laqueille, Malika El Youbi, Pierre Paris, Bernard Angerville, Alain Dervaux, Jean-François Verlhiac, Eve Legrand

This work aimed at creating a psychosocial intervention based on growth mindset theory and implementation intention strategies, in order to reduce alcohol consumption among users in the general population, and the clinical population of individuals with alcohol use disorder. A mixed method approach was used, combining qualitative and quantitative research methods among both populations. Four focus groups were first conducted to extract arguments in favor of a malleable view of alcohol consumption (study 1A), situations that trigger the desire to drink alcohol, as well as strategies used by people to counteract this need (study 1B). Data were analyzed using reflective thematic analysis in line with the scientific literature on alcohol consumption. The results were used to create a questionnaire scoring the relevance of each argument, situation and strategy (study 2). The 20 best scored arguments, situations and strategies were selected to create the intervention. The created intervention consisted in a popularized scientific article describing alcohol consumption as malleable, including the selected arguments and followed by two internalization exercises. Then, a volitional help sheet included the selected situations and solutions was presented, allowing forming up to three plans. The discussion focused on the added value of the created material compared to pre-existing tools in the literature, and presents plans to test the intervention in a future study.

Assessment of psychological terror and its impact on mental health and quality of life in medical residents at a reference medical center in Mexico: A cross-sectional study

by Víctor Manuel Enriquez Estrada, Neftali Eduardo Antonio-Villa, Omar Yaxhemen Bello-Chavolla, Carlos Fredy Cuevas-García, Pedro Luis Vargas Gutiérrez, Irma Sau-Yen Corlay Noriega, Luis Rey García-Cortés

Background

Mobbing, particularly in medical residencies, can lead to psychological terror with lasting mental and physical health consequences. Its impact on Mexican residents, however, remains underexplored.

Aim

This study aimed to investigate the prevalence and associated factors of psychological terror among medical residents at a medical center in Mexico City.

Methods

In a cross-sectional study, medical residents from various specialties were assessed for mobbing domains, quality of life, and anxiety/depression using the Leymann Inventory of Psychological Terror (LIPT), 36-Item Short Form Health Survey, Beck Depression Inventory-II, and Beck Anxiety Inventory, respectively. Psychological terror was defined as a LIPT score ≥ p80. Linear and binomial logistic regression models were used to explore independent predictors of mobbing and psychological terror.

Results

Of the 349 participants included (median age: 28; IQR: 27–30 years), 19.5% (95% CI: 15.5%-24.0%) were identified with psychological terror. Furthermore, 39% reported higher-degree trainees as mobbing perpetrators. Women in surgical residencies in their second or fifth year were found to experience higher levels of mobbing. Manifested bullying, workplace stigma, and inappropriate tasks were the most impacted mobbing domains. Anxiety, diminished mental health quality of life, and higher degree of medical specialization were independent predictors of mobbing. Meanwhile, increased anxiety, affiliation to surgical specialties, and being in the second or fifth year of training were identified as predictors of psychological terror.

Conclusions

Mobbing and psychological terror are prevalent conditions among medical residents in Mexico. Identification of occupational conditions and adverse psychological stressors can help to improve quality of life and training of medical residents.

Association between lignan polyphenol bioavailability and enterotypes of isoflavone metabolism: A cross-sectional analysis

by Tomoko Fujitani, Mariko Harada Sassa, Zhaoqing Lyu, Yukiko Fujii, Kouji H. Harada

Lignan polyphenols derived from plants are metabolized by bacteria in the gut to mammalian lignans, such as enterolactone (ENL) and enterodiol (END). Mammalian lignan intake has been reported to be associated with obesity and low blood glucose levels. However, the factors that are responsible for individual differences in the metabolic capacity for ENL and END are not well understood. In the present study, the effects of enterotypes of isoflavone metabolism, equol producers (EQP) and O-desmethylangolensin producers (O-DMAP), on lignan metabolism were examined. EQP was defined by urinary daidzein (DAI) and equol concentrations as log(equol/DAI) ≥ –1.42. O-DMAP was defined by urinary DAI and O-DMA concentrations as O-DMA/DAI > 0.018. Isoflavone and lignan concentrations in urine samples from 440 Japanese women were measured by gas chromatography-mass spectrometry. Metabolic enterotypes were determined from the urinary equol and O-DMA concentrations. Urinary END and ENL concentrations were compared in four groups, combinations of EQP (+/–) and O-DMAP (+/–). The urinary lignan concentration was significantly higher in the O-DMAP/EQP group (ENL: P

Dysfunction of peripheral somatic and autonomic nervous system in patients with severe forms of Crohn’s disease on biological therapy with TNFα inhibitors–A single center study

by Martin Wasserbauer, Sarka Mala, Katerina Stechova, Stepan Hlava, Pavlina Cernikova, Jan Stovicek, Jiri Drabek, Jan Broz, Dita Pichlerova, Barbora Kucerova, Petra Liskova, Jan Kral, Lucia Bartuskova, Radan Keil

Objective

Crohn’s disease (CD) can be associated with a wide range of extraintestinal manifestations (EIMs), including neurological ones. Published studies differ in their conclusions about the epidemiology and etiopathogenesis of neurological EIMs. The aims of this study were to demonstrate the presence and find risk factors of peripheral (somatic and autonomic) neuropathy patients with severe CD on anti-TNFα biological therapy.

Material and methods

A clinical examination focusing on detection of peripheral sensor-motor nervous dysfunction (including Sudoscan) and examination of autonomic nervous system dysfunction (using Ewing´s battery tests and spectral analysis) together with laboratory tests and collection of demographic data followed by administration of questionnaires were performed on a total of 30 neurologically asymptomatic outpatients with severe CD on anti-TNFα biological therapy.

Results

Peripheral sensor-motor nervous function via clinical neurological examination was pathological in 36.7% and Sudoscan in 33.3% of cases. Statistically significant associations between vibration perception test and age, CD and biological therapy duration, body mass index and Crohn’s Disease Activity Index were proved while statistically significant associations between temperature perception test and age and BMI were proved as well. Additionally, a decrease of total protein in a patient´s serum below the physiological cut-off in the 6 months prior to measurement was associated with a pathological result of a Sudoscan. Cardiovascular autonomic neuropathy based on Ewing´s battery tests was present in 56.7% of patients, no statistically significant risk factors were found. Our peripheral neuropathy questionnaire correlated with the results of the Sudoscan test and some tests of the clinical examination of peripheral sensor-motor nervous function (discriminatory contact perception test, temperature perception test).

Conclusions

This study demonstrated a relatively high prevalence of peripheral (especially autonomic) neuropathy and verified some risk factors for the development of peripheral somatic neuropathy in asymptomatic patients with severe form of CD on anti-TNFα biological therapy.

Calidad de Vida Relacionada con la Salud, de pacientes dializados, Hospital Puerto Montt, Chile

Objetivo: Describir variables clínicas, sociodemográficas, Calidad de Vida Relacionada con la Salud (CVRS) en Hemodiálisis (HD) y Peritoneodiálisis (PD), en Hospital Puerto Montt, Chile. Metodología: cuantitativo descriptivo, transversal. n=75 (47 HD, 28 PD). Aprobado por Comité de Ética, revisión fichas clínicas, cuestionario sociodemográfico y KDQOL-36. Resultados: 51% mujeres, 49% hombres, 56% sector urbano, 20% 51-60 años. HD: 49% casados, 36% tratamiento sobre 84 meses. PD; 43% casados, 25% tratamiento 12-48 meses. KDQOL-36: 43% HD y 54% PD perciben “Buena” su salud. Esfera física; 25%, ambas terapias, refiere limitación en actividades de la vida diaria; 38% de PD refiere dolor “moderado”. Esfera psicológica; HD 28% refiere tranquilidad y sosiego “casi siempre”; PD 35% desánimo y tristeza “algunas veces”. Conclusiones: existe impacto negativo en dimensiones de CVRS; pero, globalmente considerada “Buena”; permitiendo formular mejoras para pacientes.

Atención extrahospitalaria en trauma grave: punto de encuentro de equipos intervinientes en fase control de escenario, daños y rescate con paciente y escenario complejo

En los accidentes, cuando hay una disrupción súbita en la relación estable entre el individuo y su medio, las fuerzas violentas que intervienen originan un trauma grave, definido como lesión orgánica por alteración del entorno del individuo. La coordinación y toma de decisiones en el tándem Rescate-Asistencia in situ condiciona toda la intervención y esfuerzo de la asistencia. El resultado depende del buen funcionamiento y coordinación del grupo en toda la cadena asistencial [Fragmento de texto].

Evolución del papel de enfermería en el implante coclear

El implante coclear tiene cada vez mayor aplicación práctica en medicina. Diversos estudios demuestran los beneficios de una implantación más prematura. Explicaremos la ampliación de criterios de colocación, las nuevas pautas en preservación de audición residual, las nuevas técnicas quirúrgicas, las mejoras del material, farmacología y el papel de enfermería en dicho proceso. Objetivo principal: Recopilar los avances en conservación de audición residual y elaborar un protocolo de actuación para enfermería. Metodología: Búsqueda bibliográfica de artículos en PUBMED y CUIDEN. Tras una lectura crítica, se realizó una revisión de los mismos comparándolos con nuestra experiencia. Resultados principales: A mayor audición residual, los implantes cocleares obtienen mejores datos de audición. Conclusión principal: La conservación de la audición residual es capital en la mejora de la audición y enfermería juega un papel fundamental durante todo el proceso.